This form is to be completed only by the student's legal parent/guardian.  Please note that Acadia Middle School administration (or designee) reserves the right to contact you directly to verify the legitimacy of this form.  

If using this form, you do NOT need to call in the absence or submit a note when the student returns.

Parents/guardians requesting Early Dismissal for their student must submit this form by 11:00 a.m. otherwise please call the Attendance Office (518-881-0458).

**The information you share in this form is confidential and shared only with the office staff and nurse.**

Thank you for your cooperation.